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Ask Dr. Gott 4/9
Breast abnormality always a concern
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    DEAR DR. GOTT: I am an 82-year-old woman. I have a very puzzling problem. Since June 2007, I have had a small amount of drainage from my right breast. I saw a breast surgeon, who took a sample and ordered a blood analysis. I was told unless there was blood in the fluid, there was only about a 10 percent chance that the drainage was caused by cancer.
    I have a strong family history of cancer, so the specialist suggested I have a biopsy. He said it would be a painful process. He also gave me the option of wait and see.
    I have not done anything yet but wonder if I should. The surgeon told me he thought the drainage was from a milk-duct abnormality. What is your opinion?
    DEAR READER: Any breast drainage is a red-flag warning of possible cancer. Your breast surgeon is somewhat correct that a biopsy is an appropriate step; however. I suggest you first explore noninvasive techniques, such as a mammogram and breast ultrasound. The surgeon will be able to see the mammary glands (milk ducts), as well as the rest of the breast. These procedures should show any abnormalities.
    I would just like to mention that I am unsure how your breast surgeon would know where to do a biopsy unless he has already done imaging studies. This would be like throwing a dart at a target knowing only what wall the target is on. Chances are, if something is present, it will be missed.
    Because you have a strong family history of cancer, the drainage is persistent and you have delayed for nearly a year, I urge you to have the imaging studies. Further testing and possible treatment can then be based on those findings. Don't delay any longer. Breast cancer can be cured if caught in its early stages. There is a good chance that the drainage is benign, but without evaluation, there is no way to tell.
    To give you related information, I am sending you a copy of my Health Report "Breast Cancer and Disorders."

    DEAR DR. GOTT: When I take a children's aspirin (81 milligrams), I always get a nose bleed. Does this mean that I am allergic to aspirin? Where else could I be bleeding from?
    DEAR READER: I don't believe you're allergic to aspirin. I believe you are just sensitive to aspirin's ability to slow blood clotting. Another possible bleeding site is the gastrointestinal tract (stomach, intestine, etc.).
    Reduce your dosage or stop it completely. You do not say why you take it. If you are using it for its pain-relieving properties, I recommend ibuprofen (Advil, Motrin, etc.) or naproxen sodium (Aleve). Speak to your primary-care physician about the bleeding tendency and request a referral to a hematologist (blood specialist), who can test you for possible clotting disorders.
    As an aside, "baby aspirin" is just low-dose (81-milligram) aspirin. Do not give 81-milligram aspirin to babies, toddlers or children unless advised to by a pediatrician.
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